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Organization
LEGACY RECOVERY HEALTH CENTER
Active
Organization
LEGACY RECOVERY HEALTH CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELIJAH JACQUES LCDC-I (EXECUTIVE DIRECTOR)
(713) 636-2964
Entity
Organization
Contact information
Practice address
388 W LITTLE YORK RD, HOUSTON, TX 77076-1303
(713) 636-2964
(713) 636-9686
Mailing address
PO BOX 3342, SPRING, TX 77383-3342
(713) 636-2964
(713) 636-9686
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
NULL
251S00000X
Community/Behavioral Health Agency
—
NULL
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
10734
TX
261QM0850X
Adult Mental Health Clinic/Center
10734
TX
261QM0855X
Adolescent and Children Mental Health Clinic/Center
10734
TX
261QM1300X
Multi-Specialty Clinic/Center
10734
TX
261QR0400X
Rehabilitation Clinic/Center
10734
TX
261QR0401X
Comprehensive Outpatient Rehabilitation Facility (CORF)
Primary
10734
TX
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
10734
TX
261QR0405X
Substance Use Disorder Rehabilitation Clinic/Center
3648-3655
TX
Other
Enumeration date
06/30/2013
Last updated
03/24/2015
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